Since 1990, the number of patients with thyroid cancer has increased worldwide. If this trend continues, thyroid cancer will be among the top five most common cancers by 2030. Thyroid cancer includes various types, such as differentiated thyroid carcinoma (DTC), medullary thyroid cancer (MTC), and anaplastic thyroid cancer. The standard treatment involves partial or total removal of the thyroid gland, possibly followed by radioactive iodine (131I) to destroy remaining cancer cells. However, 15-33% of PTC patients and all MTC patients are resistant to radioactive iodine.
An important decision is the extent of the surgery. A total thyroidectomy has advantages, such as a clear diagnosis and follow-up strategy, but requires lifelong thyroid hormone replacement, which can reduce the quality of life. A hemi thyroidectomy can prevent this but carries risks, such as the potential need for a second surgery. Biopsies can be taken for laboratory research to test therapies and gain more knowledge about the tumor.
This dissertation of Luc Sondorp combines translational and clinical studies. Chapter 1 provides an overview. Chapter 2 develops patient-derived tumor organoids (PDOs) from PTC patients to determine radioactive iodine resistance before surgery. Chapter 3 focuses on PDOs from MTC, using tyrosine kinase inhibitors (TKIs) and imaging tracers for medical imaging. Chapter 4 describes a clinical study using the tracer EMI-137 for detecting PTC tumors. Chapter 5 investigates the same tracer for detecting lymph node metastases, with a negative predictive value of 83.3%. Chapter 6 describes a PDO model of parathyroid glands for testing new drugs and tracers.
